Date of Award

Spring 2023

Document Type

Project – Full Written

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Tina Lewis


Around one in every nine Emergency Department (ED) patients have Difficult Intravenous Access (DIVA) and 25% of ED patients will require more than one attempt (Fields et al., 2014a). Failed insertion attempts contribute to decreased patient satisfaction, care delays, and financial losses. The freestanding ED affiliated with a multi-state, not-for-profit healthcare system in an urban community had difficulty with first-attempt Peripheral IV (PIV) insertion success in identified patients. The target population was the clinical staff of the freestanding ED which included Registered Nurses and Paramedics. The objective outcome was to enhance personal knowledge of PIV catheter insertion in difficult-access patients and retain at least 80% of DIVA Clinical Predictor Tool education by the end of the project implementation. The project goal was that a reduction in PIV insertion attempts will result in improved patient outcomes and satisfaction. The quality improvement project was implemented with a survey method and statistical analysis was used to gather quantitative data. Two identical surveys were administered prior to and after the target population was presented with DIVA Clinical Predictor Tool education. The project data showed a 97.7% retention of DIVA Clinical Predictor Tool education after implementation. It was proven that when skilled clinicians were presented with education on the DIVA Clinical Predictor Tool and appropriate alternative insertion techniques, personal knowledge of PIV insertion in DIVA patients was improved.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License